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The TrueBlue study : is practice nurse-led collaborative care effective in the management of depression for patients with heart disease or diabetes?

Morgan, Mark, Dunbar, James, Reddy, Prasuna, Coates, Michael and Leahy, Robert 2009, The TrueBlue study : is practice nurse-led collaborative care effective in the management of depression for patients with heart disease or diabetes?, BMC family practice, vol. 10, no. Article 46, pp. 1-8.

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Title The TrueBlue study : is practice nurse-led collaborative care effective in the management of depression for patients with heart disease or diabetes?
Author(s) Morgan, Mark
Dunbar, James
Reddy, Prasuna
Coates, Michael
Leahy, Robert
Journal name BMC family practice
Volume number 10
Issue number Article 46
Start page 1
End page 8
Publisher BioMed Central Ltd.
Place of publication London, England
Publication date 2009-06
ISSN 1471-2296
Summary Background: In the presence of type 2 diabetes (T2DM) or coronary heart disease (CHD), depression is under diagnosed and under treated despite being associated with worse clinical outcomes. Our earlier pilot study demonstrated that it was feasible, acceptable and affordable for practice nurses to extend their role to include screening for and monitoring of depression alongside biological and lifestyle risk factors. The current study will compare the clinical outcomes of our model of practice nurse-led collaborative care with usual care for patients with depression and T2DM or CHD.

Methods: This is a cluster-randomised intervention trial. Eighteen general practices from regional and metropolitan areas agreed to join this study, and were allocated randomly to an intervention or control group. We aim to recruit 50 patients with co-morbid depression and diabetes or heart disease from each of these practices. In the intervention group, practice nurses (PNs) will be trained for their enhanced roles in this nurse-led collaborative care study. Patients will be invited to attend a practice nurse consultation every 3 months prior to seeing their usual general practitioner. The PN will assess psychological, physiological and lifestyle parameters then work with the patient to set management goals. The outcome of this assessment will form the basis of a GP Management Plan document. In the control group, the patients will continue to receive their usual care for the first six months of the study before the PNs undergo the training and switch to the intervention protocol. The primary clinical outcome will be a reduction in the depression score. The study will also measure the impact on physiological measures, quality of life and on patient attitude to health care delivered by practice nurses.

Conclusion: The strength of this programme is that it provides a sustainable model of chronic disease management with monitoring and self-management assistance for physiological, lifestyle and psychological risk factors for high-risk patients with co-morbid depression, diabetes or heart disease. The study will demonstrate whether nurse-led collaborative care achieves better outcomes than usual care.
Language eng
Field of Research 111714 Mental Health
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2009, Morgan et al.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30025473

Document type: Journal Article
Collections: Faculty of Health
Higher Education Research Group
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.